Endobronchial tube with integrated image sensor

ABSTRACT

An endobronchial tube comprising at least two lumens of different lengths for selectively associating with a patient about at least two locations relative to the Tracheal Carina, said tube comprising: a first lumen having an open distal end that associates proximally to the Carina within the Trachea, with a first inflatable cuff; a second lumen having an open distal end that extends distally, past the Carina and associates within one of the Left Bronchial branch and Right Bronchial branch with a second inflatable cuff; a dedicated image sensor lumen spanning the length of said first lumen, the dedicated image sensor lumen comprising an image sensor and illumination source disposed adjacent to the distal end of said first lumen, and configured to provide an image of the Tracheal bifurcation of the Tracheal Carina, the openings of the Left Bronchial branch, and the opening Right Bronchial branch; and at least one dedicated cleaning lumen disposed parallel with said dedicated image sensor lumen along the length of said endobronchial tube and wherein said cleaning lumen is configured to forms a cleaning nozzle at the distal end, wherein said cleaning nozzle is directed toward said image sensor lumen at its distal end.

FIELD OF THE INVENTION

The present invention relates to upper airway tubes and in particular,to an endobronchial tube with an integrated image sensor and lightsource.

BACKGROUND OF THE INVENTION

Respiratory tubes for example endobronchial tubes, endotracheal tubes,tracheostomy tubes are used to ventilate at least a portion of therespiratory system or lungs of a subject. Such respiratory tubes may beinserted in a number of ways via a non-invasive approach through anorifice or cavity such as the oral or nasal cavity. Alternatively suchtubes may be introduced to a body via a minimally invasive externalincision creating a port for tube insertion for example through thetrachea in a tracheotomy procedure.

Such respiratory tubes may be provided as double lumen tubes, or singlelumen tubes for selectively ventilating a portion of the respiratorysystem. For example endobronchial tubes, whether, double lumen tubes ora single lumen tube may be utilized for one-lung ventilation proceduresor for selective lung ventilation of the left or right bronchi, duringone-lung ventilation procedures.

In order to perform one-lung ventilation procedures withoutcomplications, the position of the respiratory tube placed within eitherthe left or right bronchi and the trachea must be closely monitored orat least confirmed prior to initiating a procedure. Various technologiesare available to confirm the tube's placement, for example capnograph,auscultation, bronchoscope and x-ray.

However these procedures take time, technique and skill to perform andtherefore it is not feasible to continuously monitor the tube'splacement. In particularly when the subject is moved during a procedurethe tube's location may change leading to potentially dangerousdisplacement of the tube possibly suffocating the subject orinappropriate ventilation of the patient, for example not ventilatingthe correct portion of the respiratory system.

Verification by means of a bronchoscope is currently the gold standard,but none of the mentioned confirmation techniques provide continuousmonitoring of the carina or provide for correct tube positioning.Furthermore, drawbacks with respect to the design and sensitivity of thebronchoscope, render its cleaning process elaborate and ofteninefficient and costly process, that may lead to cross infection betweensubjects.

SUMMARY OF THE INVENTION

There is an unmet need for, and it would be highly useful to have anendobronchial tube capable of continuously and seamlessly inspect thelocation and implantation of the endobronchial tube relative to theTracheal Carina.

The present invention overcomes the deficiencies of the background byproviding an endobronchial tube having an integrated image sensor andcorresponding light source.

A preferred embodiment of the present invention provides for arespiratory tube, and an endobronchial tube, designed for oral or nasalinsertion via the trachea and into a lung to maintain airway patencyand/or deliver anesthetic, inhalation agent or other medical gases, andsecure ventilation.

Most preferably the endobronchial tube of the present invention may bemade of medical grade materials for example including but not limited toplastic, rubber, polymers or silicone or the like materials as is knownin the art.

Most preferably the endobronchial tube of the present invention providesfor continuous monitoring of the Tracheal Carina (herein “TC”), allowinga user, physician, nurse, or caregiver to verify they correct placementof the endobronchial tube.

Most preferably the endobronchial tube includes an integrated imagesensor, optionally and preferably in the form of CCD or CMOS cameraprovided for visualizing the carina to confirm the correct placement ofthe tube within the trachea and bronchi, assuring correct ventilationduring procedures for example including but not limited to one lungventilation.

Most preferably the integrated camera and light source providecontinuous verification of the correct placement of the endobronchialtube. The continuous placement verification allows a caregiver theopportunity to detect any dangerous situation, for example cuffdislodgement, providing sufficient time to react to the situation as isnecessary. Moreover blood and secretion accumulation or any otherunexpected incidents during surgery, which might cause risk to thepatient, may be observed.

A preferred embodiment of the present invention provides for anendobronchial tube with an integrated image sensor, for exampleincluding but not limited to CCD or CMOS camera, with a correspondinglight source, for example including but not limited to a Light EmittingDiode (‘LED’) while optimizing the lumen patency for both adequateairflow performance through the tube. Most preferably the image sensorand corresponding light source are provided in a dedicated lumen alongthe lengh of the endobronchial tube. Most preferably the image sensor isfurther provided with a cleaning nozzle to ensure an open field of viewdistal to the image sensor. Most preferably the length of the dedicatedimage sensor lumen is provided paralleled with the length of thetracheal lumen, therein both tracheal lumen and image sensor lumen areof essentially the same length. Optionally the length of the dedicatedimage sensor lumen may be provided according to the length of thebronchial lumen.

Optionally the endobronchial tube may be iclecl lith two dedicated imagesensor lumen. Optionally a first dedicated image sensor lumen isprovided according to the length of the tracheal lumen and a seconddedicated image sensor lumen is provided according to the length of thebronchial lumen.

A preferred embodiment of the present invention provides forendobronchial tube with an integrated image sensor and light sourceprovide a continuously and unobstructed view and illumination of thecarina, left bronchi, right bronchi, bronchial cuff and bronchialbifurcations, within a single field of view.

An optional embodiment of the present invention provides for utilizingat least one or more bronchial cuff. Optionally at least two or morebronchial cuffs may be utilized to provide adequate sealing of thebronchi.

Optionally the bronchial cuff may be provided in varying shapes so as isto better fit the bronchi for example include but is not limited tospherical, elliptical, helical, hourglass, trapezoidal, or the like.

Optionally different bronchial cuff configured and shaped according toanatomy and placement location, for example anatomy based onconfiguration of a cuff for left bronchi placement and for right bronchiplacement.

Within the context of this application the term endobronchial tube maybe used interchangeably with any one of Tracheobronchial tube, doublelumen tube, double lumen endobronchial tube, double lumen endotrachealtube, to collectively refer to a tube and/or catheter utilized forselectively ventilating a subject via both lungs, one of the lungs or aportion of one or both of the lungs.

An endobronchial tube comprising at least two lumen of different lengthsfor selectively associating with a patient about at least two locationsrelative to the Tracheal Carina, the tube comprising:

-   a. a first lumen having an open distal end that associates oximally    to the Carina within the Trachea, with a first inflatable cuff;-   b. a second lumen having an open distal end that extends distaliy,    past the Carina and associates within one of the Left Bronchial    branch and Right Bronchial branch with a second inflatable cuff;-   c. a dedicated image sensor lumen spanning the length of said first    lumen, the dedicated image sensor lumen comprising an image sensor    and illumination source disposed adjacent to the distal end of said    first lumen, and configured to provide an image of the Tracheal    bifurcation of the Tracheal Carina, the openings of the Left    Bronchial branch, and the opening Right Bronchial branch; and-   d. at least one dedicated cleaning lumen disposed parallel with said    dedicated image sensor lumen along the length of said endobronchial    tube and wherein said cleaning lumen is configured to forms a    cleaning nozzle at the distal end, wherein said cleaning nozzle is    directed toward said image sensor lumen at its distal end.

Optionally, said cleaning nozzle is provided with a diameter from 0.1 mmto 2 mm.

Optionally, said cleaning nozzle is provided with a diameter of 0.6 mm.

Optionally, said cleaning lumen is provided with two or more cleaningnozzles about either side of said image sensor.

Optionally, said two or more cleaning nozzles cooperate with oneanother.

Optionally, said cleaning lumen provides for suctioning or flushing theimage sensor field of view.

Optionally, said dedicated image sensor lumen is disposed within thewall of said tube about an anterior or posterior portion between saidfirst and second lumen.

Optionally, the second lumen comprises a second image sensor oviding animage of the Right bronchi or Left bronchi.

Optionally the image sensor may be a CCD image sensor or CMOS imagesensor.

Optionally, the first lumen further comprises a light source disposedproximal to the distal end of said first lumen and adjacent to the imagesensor.

Optionally, the light source may be selected from the group consistingof a LED, optical fiber, waveguide, light guide, and any combinationthereof.

Optionally the image sensor may be disposed within a dedicated channelembedded within a wall of the first lumen.

Most preferably the image sensor may be associated with an auxiliarydevice for example including but not limited to a display and powersupply at the proximal end of the tube most preferably about the firstlumen, through a single dedicated connector for example including butnot limited to a USB connector.

Optionally the endotracheal tube may be adapted for non--invasiveinsertion through the oral cavity or nasal cavity.

Optionally the endotracheal tube may be adapted for insertion through anexternal port or incision.

Optionally the endotracheal tube may be adapted for insertion through asurgical procedure or other invasive procedure.

Unless otherwise defined, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. The materials, methods, andexamples provided herein are illustrative only and not intended to belimiting..

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is herein described, by way of example only, withreference to the accompanying drawings. With specific reference now tothe drawings in detail, it is stressed that the particulars shown are byway of example and for purposes of illustrative discussion of thepreferred embodiments of the present invention only, and are presentedin order to provide what is believed to be the most useful and readilyunderstood description of the principles and conceptual aspects of theinvention, In this regard, no attempt is made to show structural detailsof the invention in more detail than is necessary for a fundamentalunderstanding of the invention, the description taken with the drawingsmaking apparent to those skilled in the art how the several forms of theinvention may be embodied in practice.

In the drawings:

FIGS. 1A-B show schematic illustrations of an exemplary endobronchialtube according to an optional embodiment of the present invention; FIG.1A shows the endobronchial tube within the right bronchi; FIG. 1B showsthe endobronchial tube within the, left bronchi;

FIG. 2 shows a schematic sectional view of the Tracheal Carina as seenfrom the endobronchial tube according to an optional embodiment of thepresent invention;

FIG. 3 shows a perspective views of an exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 4A shows a perspective view of an exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 4B shows a close up view of notch exit point for the image sensorconnector according to the present invention;

FIG. 5 shows a perspective view of exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 6 shows a perspective view of exemplary endobronchial tubeaccording to an optional embodiment of the present invention, depictingthe curvature of the tube;

FIGS. 7A-F shows varying close up views of the distal end of theendobronchial tube according to optional embodiments of the presentinvention;

FIGS. 8A-B show cross-sectional views about different portions of theendobronchial tube according to optional embodiments of the presentinvention; and

FIG. 9 shows a close up view of the image sensor with integrated lightsource within a dedicated lumen disposed within the wall of theendobronchial tube according to an optional embodiment of the presentinvention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The principles and operation of the present invention may be betterunderstood with reference to the drawings and the accompanyingdescription. The following reference labels listed below are usedthroughout the drawings to refer to objects having similar function,meaning, role, or objective.

10 Stylet;

12 Y-connector;

14 Air Balance Cap;

20 Endobronchial Tube connector assembly;

22 Endobronchial Tube connector proximal end;

24 Tracheal lumen connector portion;

26 Bronchial lumen connector portion;

28 Endobronchial Tube connector distal end;

50 endobronchial tube system;

100 endobronchial tube;

101 sectional view;

102 tube proximal end;

104 tube distal end;

104 a distal curvature;

106 tube medial portion;

106 a medial curvature;

108 midline partition;

110 tracheal lumen;

111 tracheal lumen connector;

112 tracheal cuff;

112 n tracheal cuff notch;

114 tracheal lumen distal end;

116 tracheal lumen proximal end;

118 tracheal cuff connector;

120 bronchial lumen.;

122 bronchial cuff;

124 bronchial lumen distal end;

126 bronchial lumen proximal end;

128 bronchial cuff connector;

130 injection tube connector;

150 image sensor with integrated illumination;

150 c image sensor;

150I illumination source;

150L image sensor lumen

152 image sensor notch;

154 image sensor conductor;

156 image sensor cleaning nozzle;

158 image sensor connector;

160 cleaning lumen;

TR Trachea;

TC Tracheal Carina;

BR Right Bronchi;

BL Left Bronchi.

FIG. 1A shows a schematic illustration of an exemplary endobronchialtube 100 according to an optional embodiment of the present inventionplaced within the right bronchi (BR). FIG. 1B shows a schematicillustration of an endobronchial tube 100 within the left bronchi (LB).

Endobronchial tube 100 is a dual lumen tube comprising a first tracheallumen 110 and a second bronchial lumen 120. Most preferably a midlinepartition 108 defines the individual lumen into tracheal lumen 110 andbronchial lumen 120. Tracheal lumen 110, most preferably, ends withinthe trachea while the bronchial lumen 120 ends within the bronchi, leftor right. Therein tracheal lumen 110 and bronchial lumen 120 areconfigured to have different lengths, wherein the bronchial lumen 120extends past w and/or distally to tracheal lumen 110.

Each lumen comprises an inflatable cuff respectfully, tracheal cuff 112and bronchial cuff 122. Tube 100 is placed such that the tracheal lumen110 is placed within the Trachea by way of cuff 112 proximally, above,the tracheal carina. Most preferably the tracheal carina may becontinually is visualized with an image sensor and light source 150.Optionally image sensor and light source 150 may be integrated withintracheal lumen 110 about its distal end 114. Optionally and mostpreferably image sensor and light source 150 may be integrated within adedicated channel or peripheral lumen 150L within a wall of the tracheallumen 110. Most preferably image sensor 150 provides a cross sectionalview 101, shown in FIG. 2.

Most preferably image sensor and light source 150 are provided in theform of at least one or more light emitting diode CLEM 150I and imagesensor 150 c for example including but not limited to a CCD or CMOS,FIG. 9) providing a view 101 showing the status of the bronchi, FIG. 2.

FIG. 2 shows a schematic sectional view of the Tracheal Carina as seenfrom endobronchial tube 100, provided by image sensor and light source150, allowing the visualization of bronchial cuff 122 disposed withinthe left bronchi BL, the patency of the left bronchi, the patency of theright bronchi, the tracheal carina, bronchial bifurcation, in a singlefield of view 101. Optionally a similar view may be provided with imagesensor 150 when tube 100 is disposed with the right Bronchi BR as shownin FIG. 1A.

FIG. 3 shows endobronchial double lumen tube system 50 comprisingendobronchial tube 100 and optional various auxiliary devices that maybe used in conjunction with and/or facilitate the use of tube 100.

Optionally auxiliary devices may for example include but is not limitedto stylet 10, Y-connector 12, air balance caps 14, and an endobronchialtube connector assembly 20, or the like adjunct device utilizedfacilitating the use of tube 100 as is known in the art.

Stylet 10 most preferably is utilized to facilitate placement f tube100, as is known and accepted in the art.

Y-connector 12 most preferably provides for simultaneously connectingboth lumens of double, lumen tube 100 to a single ventilation source.

Endobronchial Tube connector assembly 20 provides for individuallyconnecting to tracheal lumen 110 and bronchial lumen 120. Connector isassembly 20 comprises a proximal end 22, distal end 28, and respectivetracheal lumen connector portion 24 and Bronchial connector portion

Most preferably proximal end 22 provides for connecting and/or otherwiseassociating the tube 100 at proximal end 102 at about the individuallumen tracheal lumen 110 and bronchial lumen 120 to auxiliary devicesfor example including but not limited to ventilation sources.

Most preferably distal end 24 provides for coupling and/or otlrerskiseassociating with tube 100.

FIG. 3 further provides a perspective view of a preferred double lumenendobronchial tube 100 comprising tracheal lumen 110 having a tracheallumen distal end 114 and bronchial lumen 120 having a bronchial lumendistal end 124.

Tube 100 further comprises tracheal cuff 112, shown its expanded state,provided for securely placing and/or anchoring tube 100 within thetrachea while ventilating the lungs through tracheal lumen 110.

Tube 100 further comprises bronchial cuff 122, shown in its expandedand/or inflated state, provided for securely placing and/or anchoringtube 100 within the bronchi, left or right. Most preferably cuff 122provides for selectively controlling the ventilation to the bronchialarch wherein it is placed (left or right). For example ventilation toeither the left or right bronchi may be completely blocked so as toallow a procedure on the respective lung (for example right) whileallowing the ventilation of the other lung (for example left) viatracheal lumen 110.

Most preferably tracheal cuff 112 may be inflated and/or deflated viacuff tracheal connector 118.

Most preferably bronchial cuff 122 may be inflated and/or deflated tovia cuff bronchial connector 128.

Most preferably injection tube connector 130 provides an access point toa dedicated lumen about each of the tracheal tube 110 and bronchial tube120, preferably for delivering drugs, suctioning liquids about trachealdistal 114 and/or bronchial lumen distal end 124.

FIGS. 4A provide a further perspective view of endobronchial tube 100,showing image sensor connector 158. Most preferably image sensorconnector 158 is provided in the form of a USB connector that providesboth for image and power supply to image sensor 150 disposed in adedicated lumen near distal end 114. Optionally and preferably imagesensor and illumination 150 may be rendered function when connected to adisplay and power source (not shown) via connector 158.

FIG. 4B provides a close up view showing the image sensor notch 152disposed about the proximal end of image sensor lumen 150L providing anexit point for image sensor conducting wires 154, most preferablyprovided for both image transfer and power supply to image sensor andillumination source 150.

FIG. 5 provides a further perspective view of tube 100 provided. from aface on view showing the separation of tracheal lumen 110 and bronchiallumen 120 at distal end 104 of tube 100.

FIG. 6 provides a further schematic illustrative depiction of tube 100showing a perspective view of tube 100 with the bronchial cuff 122 andtracheal cuff 112 removed. FIG. 6A shows the curvature provided at boththe medial section 106 and distal end 104 therein defining a medialcurvature 106 a and a distal curvature 104 a, Curvatures 104 a and 106 aare provided to so that tube 100 fits within the upper airway tract'sanatomy.

Most preferably medial curvature 106 a is provided for the ease ofaccessing and introducing tube 100 within the trachea through the oralcavity and pharynx. Most preferably, curvature 106 a, is provided withan angle from about 100 degrees to about 160 degrees.

Most preferably distal curvature 104 a is proved for ease of accessingand introducing distal end 104 into one of the bronchi, left or right.Optionally and preferably distal curvature 104 a may be specific forindividual left or right endobronchial tubes. Optionally distalcurvature may be configured to be from about 25 degrees to about 70degrees. Optionally and preferably about 35 degrees as shown.

Optionally the, length of tube 100 may be provided with a length fromabout 200 mm to about 550 mm. Optionally and preferably the length oftube 100 may be selected in accordance with a user's anatomy.

Optionally endobronchial tube 100 may be provided with different sizes,length, diameters as known and accepted in the art. Optionally tube 100may be provided with a gauge from about 26 Fr to about 44Fr, or fromabout For example the external diameter of tube 100 may be provided invarying gauges and/or sizes for example including but not limited to 28Fr, 32 Fr, 35 Fr, 37 Fr, 39 Fr and 41 Fr, within the context of thisapplication the units ‘Fr’ refer to the gauge of the tube 100 in theunits French as is a common term of the art. Alternatively the gauge andor size of tube 100 may be provided in the SI units of millimeters ‘mm’.The tube 100 according to the present invention. may be provided with anexternal diameter of about 9.3 mm, 10.7 mm, 11.7 mm, 13 mm and 13.7 mm.

Optionally and preferably the length and diameter (also referred to asgauge) of tube 100 may be correlated with one another.

FIG. 7A shows a close up view of distal end 104 of tube 100 shown inFIG. 6 providing a close up view. FIG. 7A further shows a close up viewof curvature 104 a showing the flaring of distal end 104 from thetracheal lumen into the side portion of bronchial lumen 120.

FIGS. 7A-E show various close up view of distal end 104 specific tocurvature 104 a showing the flaring and tapering of distal end 104 fromthe tracheal lumen into the side portion of bronchial lumen 120.

FIGS. 7D-E provide further close up views of the distal end of imagesensor lumen 150L and cleaning nozzle 156, most preferably provided forcleaning image sensor. Optionally and preferably cleaning nozzle 156 isprovided with an opening having a diameter from about 0.1 mm to about 2mm. Optionally and preferably cleaning nozzle 156 may be provided with adiameter of about 0.6 mm.

Image sensor 150 is most preferably provided in a dedicated lumen 150Lthat spans the length of tube 100. Most preferably lumen 150 is disposedbetween tracheal lumen 110 and bronchial lumen 120.

Most preferably distal end of lumen 150L provides for visualizing thecarina and the bronchial cuff 122, for example as shown in FIG. 2.

Most preferably the diameter of image sensor lumen 150L is variablealong the length of tube 100. Most preferably image sensor lumen 150 issmallest at the proximal end 102 and largest at the distal end 104.Optionally and preferably at proximal end 102 sensor lumen 150L isconfigured to have an elliptical cross-section. Optionally andpreferably at distal end of sensor lumen 150L is configured to have acircular cross-section.

Most preferably alongside image sensor lumen 150L is a dedicatedcleaning lumen 160 that has a distal end defining a cleaning nozzle 156,as shown, providing for cleaning image sensor 150 about its distal end.Optionally and preferably cleaning nozzle 156 is provided with acurvature and/or angle so as to direct cleaning solution, fluid, gas orthe like flowing fluid toward and/or away from integrated image sensor150 and more preferably image sensor 150 c. For example cleaning lumen160 may be utilized to clear mucus or the like biological obstructionfrom in front of integrated image sensor 150 by flushing with a flowingfluid, for example a iquid or gas, from. the proximal end of lumen 160through to its distal end at forming cleaning nozzle 156. Optionallycleaning lumen l60 may be used to clear the viewing field of integratedimage sensor 150 by applying suctioning therein suctioning in front ofthe field of view to keep it clean.

FIG. 7F shows a close up view of cleaning nozzle 156 as directed towardimage sensor 150 about the distal end of lumen 150L. Optionally andpreferably cleaning nozzle 156 is configured such that it provides formaintaining an open field of view of the Tracheal Carina for integratedimages sensor 150.

Optionally and preferably the distal end of cleaning lumen 160 may becurved such that the distal end is directed toward the distal end ofimage is sensor lumen 150L therein providing for forming at least one ormore cleaning nozzle 156 that is optionally and preferably directedtoward image sensor 150, for example as shown in FIG. 7E.

Optionally tube 100 may be provided with at least two or more cleaninglumen 160, Optionally a first cleaning lumen may be provided forflushing biological obstruction while a second cleaning lumen may beprovided for suctioning biological obstructions away from the distal end114. Optionally a plurality of cleaning lumen 160 may be disposed onopposite sides of integrated image sensor 150. Optionally a plurality ofcleaning lumen 160 may be configured to cooperate with one another, forexample a first lumen would flush biological obstructions toward adsecond cleaning lumen where the obstruction is carried away bysuctioning, Optionally at least two or more cleaning lumen may beutilized concertedly to either suction or flush obstructions distal tointegrated image sensors 150, therein most preferably ensuring an openviewing field. Optionally a plurality of ao cleaning lumen may beprovided with different diameters and or sizes.

FIG. 8A shows a cross sectional view of tube 100 about its proximal end102 having tracheal lumen 110 and a bronchial lumen 120 defined oneither side of a midline partition 108. Most preferably tube 100comprises a plurality of peripheral lumen disposed internally and/orwithin the walls of tube 100. Most preferably a plurality of peripherallumen may be disposed about the circumference of tube 100 and spanessentially the length of tube 100, about the tracheal lumen 110 and/orbronchial lumen 120. Optionally and preferably the peripheral lumen mayfor example include but is not limited to a suctioning lumen, cuffinflating lumen, electronic lumen, image sensor lumen, cleaning lumen,injection tube lumen, or the like.

Most preferably tube 100 includes a dedicated lumen 150L provided forimage sensor and integrated illumination source 150. Most preferablylumen 150L provides for housing the image sensor 150 at its distal end(FIG. 7E-F) and housing image sensor conducts for example in the form ofa wire 154, disposed along the length of lumen 150L, and a image sensornotch 152 disposed near the proximal end of lumen 150L allowing imagesensor conductor 154 and connector 158 to be disposed external to tube100.

Optionally and preferably lumen 150L is disposed about the anteriorportion of tube 100 about the middle of the cross-section of tube 100.Most preferably lumen 150L is disposed anterior to partition 108.Optionally lumen150L may be disposed about the posterior portion of tube108 therein posterior to partition 108.

Most preferably on both sides of lumen 150L are dedicated lumen runningalong the length of tube 100 and most preferably running parallel withlumen 150L. Optionally and preferably at least one or more of lumen areprovided as a dedicated cleaning lumen 160. Optionallly both lumenflanking lumen 150L may be dedicated cleaning lumen 160.

Most preferably tube wall further comprises lumen 112L and 122Lrespectively corresponding to tracheal lumen 110 and bronchial lumen120. Optionally and preferably lumen 112L and 122L are provided forinflating and/or deflating cuffs 112 and 122 respectively.

FIG. 8B shows the same image as in FIG. 8A however showing thecross-section near tracheal lumen distal end 114 of tube 100. Mostpreferably at tracheal lumen distal end 114 image sensor lumen 150L isprovided with a lumen having a larger radius than that provided at theproximal end 102 as shown in FIG. 8A. Most preferably tube 100 isexpanded about distal end 104 and lumen 150L to accommodate integratedimage sensor 150. Optionally image sensor lumen 150 about the externalsurface of tube 110 is widened and/or expanded 1.5 mm to 5 mm fromdistal end 114 of tracheal lumen 110.

Optionally the image sensor dedicated lumen 150L is provided with annotch 150 n disposed 22.5 mm from the proximal end 102 of tube 100 and aexit notch having a diameter of about 1.5 mm.

FIG. 9 shows a close up bottom-up view of the integrated image sensor150 within dedicated electronics lumen 150L disposed within the wall isof the endobronchial tube 100, showing image sensor 150 c optionally andpreferably provided in the form of a CCD or CMOS or the like, andillumination source 150I most preferably provided in the form of atleast one and more preferably at least two or more LED, as shown.

While the invention has been illustrated primarily with reference to aleft bronchi endobronchial tube, it will be appreciated that the presentinvention is not limited to a left bronchi endobronchial tube where theinventive and novel aspects equally covers a right bronchi endobronchialtube.

While the invention has been described with. respect to a limited numberof embodiments, it will be appreciated that many variations,modifications and other applications of the invention may be made.

What is claimed is:
 1. An endobronchial tube comprising at least twolumens of different lengths for selectively associating with a patientabout at least two locations relative to the Tracheal Carina, said tubecomprising: a. a first lumen having an open distal end adapted toassociate proximally to the Carina within the Trachea, with a firstinflatable cuff; b. a second lumen having an open distal end adapted toextend distally, past the Carina and associate within one of the LeftBronchial branch and Right Bronchial branch with a second inflatablecuff; c. a dedicated image sensor lumen spanning the length of saidfirst lumen, located within a wall of said tube between said first lumenand said second lumen, the dedicated image sensor lumen comprising animage sensor and illumination source disposed adjacent the distal end ofsaid first lumen, and configured to provide an image of the Trachealbifurcation of the Tracheal Carina, the openings of the Left Bronchialbranch, and the opening Right Bronchial branch; and d. at least onededicated cleaning lumen disposed parallel with said dedicated imagesensor lumen along the length of said endobronchial tube, disposedwithin said wall of said tube between said first lumen and said secondlumen, and wherein said cleaning lumen curves at the distal end to forma cleaning nozzle, such that the distal end of said cleaning lumen isdirected toward the distal end of said image sensor lumen.
 2. The tubeof claim 1, wherein said cleaning nozzle is provided with a diameterfrom 0.1 mm to 2 mm.
 3. The tube of claim 2, wherein said cleaningnozzle is provided with a diameter of 0.6 mm
 4. The tube of claim 1,wherein said cleaning lumen is provided with two or more cleaningnozzles about either side of said image sensor.
 5. The tube of claim 4,wherein said two or more cleaning nozzles cooperate with one another. 6.The tube of claim 1, wherein said cleaning lumen provides for suctioningor flushing the image sensor field of view.
 7. The tube of claim 1,wherein said dedicated image sensor lumen is disposed within the wall ofsaid tube about an anterior or posterior portion between said first andsecond lumen.
 8. The endobronchial tube of claim 1, wherein said secondlumen comprises a second image sensor providing an image of the Rightbronchi or Left bronchi.
 9. The endobronchial tube of claim 1, whereinsaid image sensor is a CCD image sensor or CMOS image sensor.
 10. Theendobronchial tube of claim 1, wherein said light source is selectedfrom the group consisting of a LED, optical fibre, waveguide, lightguide, and any combination thereof.
 11. The endobronchial tube of claim1, adapted for non-invasive insertion through the oral cavity or nasalcavity.
 12. The endobronchial tube of claim 1, adapted for insertionthrough an external port or incision.
 13. The endobronchial tube ofclaim 1, adapted for insertion through surgery or other invasiveprocedure.